Liu Xiangmin, Bai Xinyu, Ren Rong, Tan Lu, Zhang Ye, Lan Huizhen, Yang Qianlan, He Jianqing, Tang Xiangdong
West China School of Nursing, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.
Front Psychiatry. 2022 Oct 20;13:985823. doi: 10.3389/fpsyt.2022.985823. eCollection 2022.
Depression and anxiety are major psychological issues among patients with tuberculosis (TB) owing to chronic and complex treatments, have been reported to be closely correlated with immune and inflammation. However, the association of peripheral immune-inflammatory characteristics with depression/anxiety symptoms in in-patients with TB has rarely been reported.
A cross-sectional study of 338 in-patients with TB from 3 hospitals in China were enrolled to investigate their depression and anxiety status by using the nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalized Anxiety Disorder Scale (GAD-7). Participants were divided into groups based on their PHQ-9 and GAD-7 scores, and differences in demography and immune-inflammatory characteristics were studied. Logistic analysis was performed to explore factors related to depression and anxiety symptoms.
Depression and anxiety prevalence among patients with TB was 47.9 and 42.6%, respectively. Furthermore, 38.5% of patients reported a comorbidity of depression and anxiety symptoms. The counts of CD3, CD4, CD8, and lymphocytes decreased, whereas those of neutrophils, platelets, and peripheral blood cells and their derived indices increased among TB patients with depression or anxiety in comparison with those without symptoms ( < 0.05). In addition, increasing age, lower income (monthly income ≤ 3,000 yuan), divorced or widowed, drug resistance, and higher systemic immune inflammation index (SII) were significantly associated with depression or anxiety symptoms ( < 0.05).
Approximately half of the patients with TB suffered from depression or/and anxiety symptoms. Patients with depression or anxiety present worse cell immune status and stronger inflammatory responses compared to those without symptoms. We emphasized the importance of paying attention to the dysfunction of immune-inflammation process of TB patients with depression or anxiety symptoms. Especially, SII has a potential application value in guiding the evaluation of TB-related depression or anxiety owing to its easily accessibility and being economical.
由于结核病（TB）治疗的长期性和复杂性，抑郁和焦虑是结核病患者中的主要心理问题，据报道与免疫和炎症密切相关。然而，结核病住院患者外周免疫炎症特征与抑郁/焦虑症状之间的关联鲜有报道。
对来自中国3家医院的338例结核病住院患者进行横断面研究，使用九项患者健康问卷（PHQ-9）和七项广泛性焦虑障碍量表（GAD-7）调查他们的抑郁和焦虑状况。参与者根据其PHQ-9和GAD-7评分分组，研究人口统计学和免疫炎症特征的差异。进行逻辑分析以探索与抑郁和焦虑症状相关的因素。
结核病患者中抑郁和焦虑的患病率分别为47.9%和42.6%。此外，38.5%的患者报告有抑郁和焦虑症状合并症。与无症状的结核病患者相比，有抑郁或焦虑的结核病患者的CD3、CD4、CD8和淋巴细胞计数减少，而中性粒细胞、血小板、外周血细胞及其衍生指标增加（<0.05）。此外，年龄增加、收入较低（月收入≤3000元）、离婚或丧偶、耐药以及较高的全身免疫炎症指数（SII）与抑郁或焦虑症状显著相关（<0.05）。
约一半的结核病患者患有抑郁或/和焦虑症状。与无症状患者相比，抑郁或焦虑患者的细胞免疫状态更差，炎症反应更强。我们强调了关注有抑郁或焦虑症状的结核病患者免疫炎症过程功能障碍的重要性。特别是，SII因其易于获取且经济，在指导评估结核病相关抑郁或焦虑方面具有潜在应用价值。
